Louisiana
Board of Licensing
BLACKWELL JERRY DALE
Medical
License number
ATH.J00235
Date expires
06/30/2015
Class
Medical
Status
Active
Address
THIBODAUX HIGH SCHOOL, 1355 TIGER DR, THIBODAUX, LA 70301
louisianalicensing.com
ID 21761172
LAST UPDATED 2026-05-30 23:33:41 UTC
LAST UPDATED 2026-05-30 23:33:41 UTC